Tag Archives: Type 2 Diabetes

Depression a direct cause of type 2 diabetes. How can it be managed?

Diabetes News

A recent genetic study from UK scientists suggests that depression may be a direct cause of type 2 diabetes, which could support attempts to prevent the disease.

Over 500 million individuals worldwide have type 2 diabetes, which has been linked to depression through shared genetics and a causal association, according to The Guardian.

Following the study, suggestions have been made for depression to be added to the list of type 2 diabetes risk factors, along with other variables including obesity, inactivity, and a family history of the disease.

Both diseases have historically been associated with one another as people having type 2 diabetes are twice as likely to be diagnosed with depression than the general population. According to Dr Shaunak Ajinkya, Consultant, Psychiatrist, Kokilaben Dhirubhai Ambani Hospital, Mumbai, depression and type 2 diabetes have a bidirectional relationship, meaning they can influence each other and increase the risk of the other condition.

Although it was never made clear whether type 2 diabetes led to depression or vice versa, or if other factors, including obesity, were also at play. This research suggests that depression causes diabetes, rather than the other way around.

What is the relationship between depression and type 2 diabetes?

Depression can be a risk factor for type 2 diabetes because it can affect various aspects of a person’s life that are closely related to diabetes development.

Chronic stress and depression can lead to unhealthy behaviors like overeating, physical inactivity, and poor sleep, which can contribute to obesity and insulin resistance, both of which are a major risk factor for type 2 diabetes, explained Dr Sanjay Singh, General Physician, Cygnus Laxmi Hospital.

A person with a history of depression or a family history of type 2 diabetes are at higher risk. (Source: Freepik)

Additionally, depression can impact the body’s stress response system and lead to dysregulation of hormones involved in glucose metabolism, such as cortisol, insulin, and glucagon, as per Dr Ajinkya, who added that this dysregulation also contributes to the development of insulin resistance.

On the other hand, type 2 diabetes can also be a risk factor for developing depression. “The burden of managing a chronic illness, the stress associated with it, and the potential for complications can significantly affect a person’s mental health and increase the risk of depression,” Dr Ajinkya said.

What are the risk factors of developing type 2 diabetes in individuals with depression?

Assessing the risk can be done through a combination of factors, according to the experts, including:

Medical history

A person with a history of depression or a family history of type 2 diabetes are at higher risk.

Lifestyle factors

Assessing the person’s lifestyle habits, including diet, physical activity levels, and substance abuse, can help determine their risk.

Physical examination

Checking for signs of obesity or other metabolic abnormalities can provide an indication of diabetes risk.

Blood tests

Assessing fasting blood glucose levels and HbA1c (average blood glucose levels over the past few months) can help determine if a person has diabetes or is at risk of developing it.

Managing depression to reduce the risk of developing diabetes involves a multi-faceted approach. (Source: Getty Images/ Thinkstock)

If someone with depression is identified to be at risk of developing type 2 diabetes, interventions such as lifestyle modifications, regular physical activity, and mental health assessment and support may be recommended to reduce the risk and improve overall well-being.

Apart from depression, these experts say that several other risk factors can increase the likelihood of developing type 2 diabetes:

  • Family history of diabetes
  • Obesity or excess body weight, especially around the abdomen
  • Sedentary lifestyle
  • Poor diet high in sugar and unhealthy fats
  • High blood pressure
  • Age (risk increases with age)
  • Ethnicity (certain ethnic groups are at higher risk)

How to manage depression so that it doesn’t end up in the development of diabetes?

Managing depression to reduce the risk of developing diabetes involves a multi-faceted approach, as per the experts, such as:

Seek professional help and build a support system

Consult with a mental health expert or therapist to address and manage your depression. This may include therapy, such as cognitive-behavioral therapy (CBT), if necessary.

Seek support from friends, family, or support groups. Sharing your feelings and experiences with others who understand can help alleviate symptoms of depression.

Adopt a healthy lifestyle

Focus on regular exercise, a balanced diet, and weight management to improve insulin sensitivity and overall health. Alcohol and certain substances worsen symptoms of depression and increase the risk of developing diabetes, so it’s best to avoid their use.

Depression can be a risk factor for type 2 diabetes because it can affect various aspects of a person’s life that are closely related to diabetes development. (Source: Pixabay)

Get enough sleep

Prioritise a regular sleep schedule and aim for 7 to 9 hours of quality sleep every night. Poor sleep can worsen symptoms of depression and increase the risk of developing diabetes.

Stress management

Practice relaxation techniques such as mindfulness, yoga, or meditation to reduce stress levels. Find healthy ways to cope with stress like engaging in hobbies or activities which you enjoy.

Medication, if needed

In some cases, medication may be necessary to treat depression, and it’s essential to follow a healthcare provider’s guidance. If you are taking medication for depression, it’s important to take it as prescribed and attend regular follow-up appointments with your healthcare provider.

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Regular monitoring

If you’re at risk, maintain regular check-ups with your healthcare provider to monitor your blood sugar levels and overall health.

Remember that a collaborative approach involving mental health professionals, primary care physicians, and lifestyle modifications is crucial to manage both depression and reduce the risk of type 2 diabetes effectively.

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Analysis of remission and relapse rate of type 2 diabetes mellitus in Japan

Diabetes News

The phenomenon of improvement of glucose to levels in a normal range and cessation of the need for medication can occur in some patients diagnosed with type 2 diabetes who are provided with lifestyle therapy, temporary pharmacotherapy, bariatric surgery, or combinations of these treatments.

However, this phenomenon is not yet fully understood in routine care settings, and many factors remain to be clarified. Moreover, since there are differences in insulin secretion and resistance between East Asian and Western populations, the natural history of diabetes seems to differ widely between Western populations and East Asians.

Therefore, these concerns lead Dr. Kazuya Fujihara and colleagues to investigate the incidence/one year relapse from remission and associated factors in patients with type 2 diabetes. In the Diabetes, Obesity and Metabolism paper, the authors addressed these research questions using a database of specialists’ clinics.

They analyzed the data of Japan Diabetes Clinical Data Management Study Group (JDDM) which is one of the largest cohorts of Japanese people with type 2 diabetes. They tracked the information on 48,320 people with diabetes in Japan. In one arm of the study, they calculated remission rates per 1000 person-years. The authors reported that the median follow-up was 5.3 years. During the study period, 3,677 remissions occurred.

The overall incidence of remissions per 1,000 person-years was 10.5 that was similar to 9.7 in the United Kingdom. In addition, those with HbA1c levels of 48 to 53 mmol/mol (6.5% to 6.9%), those taking no glucose-lowering drugs at baseline, and those with a ≥10% body mass index (BMI) reduction in 1 year, it was 27.8, 21.7 and 48.2, respectively.

Male sex, shorter duration, lower baseline HbA1c, higher baseline BMI, higher BMI reduction at 1 year, and no glucose-lowering drugs at baseline were significantly associated with remission. Similar results were obtained with maintenance of remission over 1 year as an outcome. In another arm of the study, the investigators revealed the factors that predicted relapse from remission in 1 year.

Among 3,677 individuals who entered remission, two-thirds (2,490) relapsed from remission within 1 year. Longer duration of diabetes, lower BMI at baseline, and lower BMI reduction at 1 year were significantly associated with relapse. Commenting on the significance of their findings.

Compared to Westerners, Asians have higher insulin sensitivity and a lower acute insulin response. In addition, Asians have a much lower obesity level than Westerners, and the pathogenesis of diabetes mellitus is very different between the two. Therefore, the relationships of baseline BMI and BMI reduction with remission and relapse may be greater in East Asian than in Western populations, implying ethnic differences in returning from overt hyperglycemia to nearly normal glucose levels.”

Hirohito Sone, Niigata University

While the findings of these analytical study are impressive and provide new insight on remission in patients with type 2 diabetes should be, the authors noted that “present study is an observational study and does not show a cause and effect relationship, and that future intervention studies with lifestyle and/or medication will be needed to confirm how many people actually achieve remission and how long the state of remission lasts in real world setting”.


Journal reference:

Fujihara, K., et al. (2023) Incidence and predictors of remission and relapse of type 2 diabetes mellitus in Japan: Analysis of a nationwide patient registry (JDDM73). Diabetes, Obesity and Metabolism. doi.org/10.1111/dom.15100.

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